chronicling the high cost of our legal system

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    (for drug, medical device and implant controversies, see product liability

    Overlawyered.com commentary [through mid-June 2003. Items after that date collected here]:

    "Texas's giant legal reform", Jun. 18-19, 2003.

    Malpractice suit crisis, 2003: "Letter to the editor", Jun. 20-22; "Docs leaving their hometowns", Jun. 12-15; "Juggling the stats", Jun. 4-5; "Malpractice studies", May 12; "Public Citizen's bogus numbers", Apr. 10-13; "Malpractice crisis hits sports-team docs" (& general roundup), Apr. 7-8; "Would you go into medicine again?", Mar. 18; "'Public deceit protects lawsuit abuse'", Mar. 15-16; "One solution to the malpractice crunch", Feb. 19; "Feinstein set to back Bush malpractice plan", Feb. 12; "State of the Union", Jan. 29; "Malpractice-cost trends", Jan. 24-26; "ATLA's hidden influence", Jan. 21-22; "Playing chicken on malpractice reform", Jan. 9; "'Doctors strike over malpractice costs'" (W.Va., Pa.), Jan. 3-6.  2002: "Campaign roundup", Nov. 4-5; "Pennsylvania House votes to curb venue-shopping", Oct. 11-13; "Rumblings in Mississippi", Oct. 9-10 (& Sept. 9-10); "Let 'em become CPAs", Oct. 7-8; "Tour of the blogs", Sept. 24; "You mean I'm suing that nice doctor?", Aug. 1; "'Bush urges malpractice damage limits'", Jul. 29; "'Trauma center reopens doors'", Jul. 18; "Malpractice crisis latest" (Pa., Tex.), Jun. 11-12; "Sick in Mississippi?  Keep driving", Jun. 3-4 (& Apr. 5-7); "'Rocketing liability rates squeeze medical schools'", May 28-29; "'The trials of John Edwards'", May 20-21; "Ob/gyns warn of withdrawal", May 17-19; "'The Tort Mess'" (Forbes, etc.), May 13; "Texas doctors' work stoppage", Apr. 11 (& Mar. 15-17); "No more ANZAC Day marches?" (Australia), Apr. 1-2; "Scenes from a malpractice crisis", Mar. 5; "Med-mal: should doctors strike?", Jan. 21-22.  2001:  "Soaring medical malpractice awards: now they tell us", Sept. 11; "'Valley doctors caught in "lawsuit war zone"'", May 3; "Pennsylvania MDs drop work today", Apr. 24; "Philadelphia juries pummel doctors", Jan. 24-25.  2000: "Trial lawyers' clout in Albany", Oct. 4; "Malpractice outlays on rise in Canada", Oct. 2. 

    Ob/gyn, 2003: "Juggling the stats", Jun. 4-5; "Malpractice studies", May 12; "'Edwards doesn't tell whole story'", Mar. 4 (& letter to the editor, Mar. 31); "'Delivering Justice'", Feb. 27.  2002: "Ob/gyns warn of withdrawal", May 17-19 (& see Jun. 11-12); "'Support case hinges on failed sterilization'" (Ind.), Apr. 26-28; "Med-mal: should doctors strike?", Jan. 21-22.  2001: "Fleeing obstetrics, again", Dec. 21-23; "'Wrongful life' comes to France", Dec. 11 (& updates Jan. 9-10, May 20-21, Jul. 1-2, 2002); "Meet the 'wrongful-birth' bar", Aug. 22-23 (& letter to the editor, Sept. 3; more on wrongful birth/life: Nov. 22-23, Sept. 8-10, June 8, May 9, Jan. 8-9, 2000); "Pennsylvania MDs drop work today", April 24; "Caesarean rate headed back up", Feb. 5.  2000: "Birth cameras not wanted", Oct. 18; "Plastic surgeons must weigh patients' state of mind, court says" (roundup: anti-abortion suits), Aug. 15.  1999: "'Trial lawyers on trial'" (Norplant, etc.), Dec. 23-26; "'Your perfect birth control...blocked?'", Aug. 11 (Norplant) (& update Aug. 27; company to settle 36,000 suits); "Yes, this drug is missed" (hospital admissions for hyperemesis tripled after lawyers drove Bendectin off market), Jul. 21. 

    "Malpractice studies", May 12, 2003; "Radiologists: sue them enough and they'll go away", Nov. 2, 2000 (& see Sept. 24, 2002).

    Nursing homes, geriatrics, 2003: "Florida: 'New clout of trial lawyers unnerves legislators'", Mar. 20; "$12,000 a bed", Mar. 19.  2001: "Soaring medical malpractice awards: now they tell us", Sept. 11; "'Doctor liable for not giving enough pain medicine'", Jun. 15-17; "'Nursing homes a gold mine for lawyers'", Mar. 13-14.  2000: "'Litigation grows in ailing nursing home industry'", Jun. 20 (& see Mar. 2-4, 2001). 

    "Incoming link of the day", Mar. 5-7, 2003.

    Emergency medicine: "'Trauma centers warn lives could be at risk'" (Orlando), Feb. 28-Mar. 2, 2003; "Ambulances, paramedics sued more", Oct. 28-29, 2002; "Let 'em become CPAs", Oct. 7-8; "Avoid having a medical emergency in Mississippi", Apr. 5-7; "Scenes from a malpractice crisis" (closure of trauma centers), Mar. 5, 2002  (& see Jun. 11-12); "That'll teach 'em" (Chicago EMS), Dec. 26-28, 2000; "Highway responsibility" (ambulance, hospital sued in Derrick Thomas crash), Nov. 28, 2000. 

    "The jury pool he faced", Feb. 25, 2003.

    "Take care of myself?  That's the doc's job", Feb. 14-16, 2003; "Claim: docs should have done more to help woman quit smoking and lose weight" (Pa.), Sept. 18-19, 2002.

    "Medical mistakes" estimates, 2001:  "Report: 'medical errors' study overblown", July 27-29.  2000: "'Report on medical errors called erroneous'", July 11; "Medical mistakes, continued", March 7; "'Medical errors' study", Feb. 28; "Against medical advice" (Clinton proposals), Feb. 22 (& see malpractice law section below). 

    "Mercury in dental fillings", Jul. 16-17, 2002 (& Nov. 4-5, 2002). 

    Psychiatry and allied fields, 2002: "'Mom who drugged kids' ice cream sues'", Nov. 1-3; "'Patient sues hospital for letting him out on night he killed'" (Australia, psychiatric case), Oct. 16-17; "'After stabbing son, mom sues doctors'", May 31-June 2; "Counseling center may face closure" (Okla.), May 24-26.  2000: "Killed his mother, now suing his psychiatrists", Oct. 2; "Not my fault, I" (woman who murdered daughter sues psychiatrists), May 17; "Legal ethics meet medical ethics" (lawyers advise schizophrenic murder defendant to go off his medication for trial), Feb. 26-27 (update, Mar. 2: he's reported to have punched a social worker twice since going off medication; Mar. 29: jury convicts him anyway); "Latest excuse syndromes" ("Internet intoxication", etc.), Jan. 13-14; "Warn and be sued" (clinical psychologist loses confidentiality suit after warning of patient's dangerousness), Jan. 12.  1999: "Doctor sues insurer, claims sex addiction", Oct. 13; see also personal responsibility

    "Artificial hearts experimental? Who knew?", Oct. 23, 2002.

    "U.K.: 'Dr. Botch' sues hospital for wrongful dismissal", Oct. 18-20, 2002; "Let them sue us!" (hospitals get sued if they withdraw privileges from questionable doctors), Mar. 23, 2000. 

    "Lawyers fret about bad image" (lawyers' own poll finds public has much more confidence in doctors than in lawyers), Oct. 3, 2002.

    "'Patient pays price for suing over cold'" (U.K.), Sept. 20-22, 2002.

    "'Doctors hope fines will curb frivolous lawsuits'", Sept. 6-8, 2002; "The doctor strikes back" (neurosurgeon countersues), June 14-15, 2000; "'Truly egregious' conduct" (court cites misconduct by attorney Geoffrey Fieger in suit against cardiologist), Sept. 14, 1999. 

    "Accident medicine", 2002: "'How to spot a personal injury mill'", Aug. 19.  2001: "Lawyers (and docs) block cleanup of Gotham crash fraud", April 2.  2000: "'How do you fit 12 people in a 1983 Honda?'", Aug. 23-25; "His wayward clients", May 25; "Less suing = less suffering" (NEJM whiplash study), Apr. 24 (& update Jun. 26). 

    "'The NFL vs. Everyone'" (medical privacy laws could restrict sports teams from commenting on players' injuries), Jun. 13, 2002; "Promising areas for suits" (sports medicine), Dec. 7, 2000; "Doctor cleared in Lewis cardiac case", May 15, 2000. 

    "'Remove child before folding'" (AEI-Brookings study on defensive medicine), Jun. 5, 2002. 

    Managed care/HMOs, 2002: "'Bad movie, bad public policy'" (John Q), Mar. 19; "Washington Post blasts HMO class actions", Jan. 30-31.  2001: "Managed care bill: Do as we say...", Sept. 7-9 (& Dec. 6, 1999); "Contrarian view on PBR", Aug. 17-19; "Chapman, Broder, Kinsley on patients' rights", June 28; "Managed care debate", June 26; "Columnist-fest" (Morton Kondracke), June 22-24; "Docs and Dems", June 19; "Roundup", May 21.  2000: "Patients' Bill of Wrongs" (Richard Epstein), Oct. 27-29; "Fortune on Lerach", Aug. 16-17; "Arm yourself for managed care debate", April 20; "Employer-based health coverage in retreat?", March 31-April 2.  1999: "Weekend reading: columnist-fest" (John McCarron), Dec. 11-12; "Actions without class" (Wash. Post editorial: "extortion racket"), Dec. 2; "Who's afraid of Dickie Scruggs?", Dec. 2; "Aetna chairman disrespects Scruggs", Nov. 18-19; "World according to Ron Motley" (world's richest lawyer plans to sue HMOs, nursing homes, drugmakers), Nov. 1; "Deal with us or we'll tank your stock" (managed care stock prices plunge), Oct. 21; "'Health care horror stories are compelling but one-sided'", Oct. 16-17; "After the HMO barbecue", Oct. 12; "Power attracts power" (Boies joins anti-HMO effort), Sept. 30; "Impending assault on HMOs",  Sept. 30; "Rude questions to ask your doctor" (why are you helping trial lawyers make it easier to sue health plans?), Sept. 4-6; "From the fourth branch, an ultimatum" (leading trial lawyer vows to "dismantle" managed care), July 16

    "Hospital rapist sues hospital", May 22-23, 2002 (& Mar. 5-7, 2003: court dismisses case). 

    "Bush's big mistake on mental health coverage", May 13, 2002. 

    "'Big government ruined my long weekend'" (tide-over weekend prescribing), May 7, 2002. 

    "Lawyers stage sham trial aimed at inculpating third party", Mar. 22-24, 2002. 

    "All things sentimental and recoverable" (veterinarians), Jan. 30-31, 2002. 

    Public health follies: "Infectious disease conquered, CDC now chases sprawl", Nov. 9-11, 2001; "Letter to the editor" (activist doctors vs. gun ownership), May 18, 2001; "'P.C., M.D.'", Feb. 23-25, 2001. 

    "Bioterrorism preparedness" (laws hobble hospitals), Oct. 30, 2001. 

    "Letter to the editor", Sept. 3, 2001 (can/should doctors avoid lawyers as patients?) (responses, Oct. 22). 

    "Clinical trials besieged", Aug. 27-28, 2001; "Bioethicist as defendant" (Arthur Caplan, Jesse Gelsinger case), Oct. 6-9, 2000. 

    "'Doctor liable for not giving enough pain medicine'", Jun. 15-17, 2001. 

    "The unconflicted Prof. Daynard" (British Medical Journal and tobacco lawyer), April 21-23, 2000 (& update: letters, Jan. 2001, June 2001). 

    "To destroy a doctor" (lawyer's campaign against laparoscopic surgeons), June 6, 2001. 

    "Mommy, can I grow up to be an informant?", July 30, 2001; "A case of meta-False Claims" (overzealous prosecution of hospitals), Sept. 9, 1999. 

    "Updates" (Lawyers' cameras in trauma ward), Dec. 26-28, 2000 (& Oct. 18). 

    "Promising areas for suits" (laser eye surgery), Dec. 7, 2000. 

    Plastic surgery: "Plastic surgeons must weigh patients' state of mind, court says", Aug. 15, 2000 (& June 11, 2001: she loses); "Strippers in court", Jan. 28, 2000; "No spotlight on me, thanks" (leading breast-implant lawyer obtains gag order against lawyers for dissatisfied clients), August 4, 1999; "Never saying you're sorry" (implants), July 2, 1999. 

    "Turn of the screw" (pedicle screw lawsuits), Oct. 24, 2000. 

    "Disabled rights roundup" (obligatory sign interpreters at doctor's offices), Sept. 29-Oct. 1, 2000; "From our mail sack: ADA enforcement vignettes" (interpreters, guide dog allergy case), May 31, 2000. 

    "Embarrassing Lawsuit Hall of Fame" (intimate injury; misdiagnosis charge), Aug. 14, 2000. 

    "Senator Lieberman: a sampler" (cost of defensive medicine), Aug. 8-9, 2000. 

    "And don't say 'I'm sorry'" (nurse's first-person account), June 21, 2000. 

    "Can't sue over affair with doctor" (court rules it was consensual), June 13, 2000. 

    "Jumped ahead, by court order" (residency), May 31, 2000.

    "'Case's outcome may spur more lawsuits'" (Mississippi fen-phen trial), Dec. 10, 1999; "'Dieters still want fen-phen'", August 18, 1999. 

    "Rhode Island A.G.: let's do latex gloves next", Oct. 26, 1999. 

    "Michigan high court upholds malpractice reform", August 6, 1999. 

    Other resources on medicine and litigation:

    Good general links pages on health law are provided by the St. Louis University Center for Health Law Studies and by the whimsically named but highly useful Health Hippo

    The Litigation Explosion, the 1991 book by Overlawyered.com editor Walter Olson, was excerpted in two parts by Medical Economics [part one] [part two

    Marc Arkin, "Products Liability and the Threat to Contraception" (Manhattan Institute Civil Justice Memo, February 1999). 

    L. William Luria, M.D., and Dennis G. Agliano, M.D., "Abusive Medical Testimony: Toward Peer Review", describes efforts under way in Hillsborough County, Florida, to apply principles of peer review to the control of irresponsible or unqualified forensic testimony by medical professionals. 

    Walter Olson, "Lawyers with Stethoscopes: Clients Beware" (Manhattan Institute Civil Justice Memo, 1996) (abusive litigation is also bad for the medical prognosis of claimants) 

    Breast implants: see separate page


    Health Hippo vaccines section. 

    Peter Huber, "Dan Quayle, the Lawyers and the AIDS Babies", Forbes, October 28, 1991 (liability and an AIDS vaccine). 

    Peter Huber, "Health, Death, and Economics", Forbes, May 10, 1993 ("investment in vaccines remains far lower than it should be, given the huge benefits that vaccines provide") 

    Walter Olson, "California Counts the Costs of Lawsuit Mania", Wall Street Journal, June 3, 1992 (liability slowing research on AIDS vaccine). 

    Malpractice law:

    Daniel Kessler and Mark McClellan of Stanford won the Kenneth Arrow Award in Health Economics in 1997 for their article "Do Doctors Practice Defensive Medicine?", which "found that when states reformed malpractice laws to put caps on damages for pain and suffering, or to eliminate punitive damages, hospital expenditures for heart disease patients were reduced by about 5 percent, yet did not leave the patients with worse health outcomes." 

    Richard Anderson, M.D., "An 'Epidemic' of Medical Malpractice?  A Commentary on the Harvard Medical Practice Study", Manhattan Institute Civil Justice Memo, July 1996 (shortcomings of famous study of medical care in New York hospitals). 

    Forbes columns by Peter Huber on the issue include "Malpractice Law: A Defective Product" (1990) and "Rx: Radical Lawyerectomy" and "Easy Lawsuits Make Bad Medicine" (1997). 

    Walter Olson, "A Story That Doesn’t Have a Leg To Stand On," Wall Street Journal, March 27, 1995 (the famous "wrong-leg amputation" case). 

    In 1993, in a paper given at the annual meeting of the Association for Health Services Research, Daniel Mendelson and Robert Rubin estimated that defensive medicine practices in three areas alone -- pre-surgical testing, fetal monitoring and skull x-rays -- probably exceeded $2 billion a year, and estimated likely savings from "aggressive malpractice reform" at more than twice that amount.  Perhaps in contrast (or perhaps not), a 1995 study of obstetrics in Washington state by L. Baldwin et al found no differences in practice between doctors who had been named in suits and those who had not. And Mark Hauser et al, "Fear of Malpractice Liability and its Role in Clinical Decision-Making" studied doctors' reaction to hypothetical cases in which a patient's file did or did not reveal a history of having sued physicians.  They found that in cases where an earlier suit had been reported the doctors were modestly more likely to call in other doctors, to recommend hospital admission, to document a case "by the book" rather than rely on judgment, and to predict a bad outcome.  Surprisingly, they did not order more tests or withdraw from cases more often when informed that a patient had a record of suing.  The Hauser paper notes one possible cost of an over-hasty resort to hospitalization: "In psychiatry a defensive response might include a needlessly low threshold for involuntary hospitalization, where the patient's liberty and autonomy are, in essence, sacrificed in favor of conservative practice for the sake of self-protection." 

    The Michigan law firm of Garan, Lucow, Miller & Seward, P.C., which has a specialty in medical malpractice defense, maintains a comprehensive links page of resources in the field. 

    Among reform groups, the Health Care Liability Alliance is a nationwide advocacy group whose website offers a variety of useful materials on the case for lawsuit reform. Californians Allied for Patient Protection defends the Golden State's MICRA limits on malpractice liability.  CLYSIS is a Minnesota group working for medical liability reform.  State medical societies, such as the Medical Society of the State of New York, often maintain law-related information at their websites. 


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